Seafarers insured in Belgium living in a EU country

Seafarers

 

Social security

General information

In the following paragraphs we will try to offer you some practical information on the social security consequences of working under the Belgian or Luxemburg flag. Considering the extent of detail this subject comprises, the information provided will be by no means entirely exhaustive. We will however try to set out the general rules in the various domains, focusing on the most useful, practical aspects. In doing this, we always work from the premise that you work on a Belgian or Luxemburg flag vessel and live in another EU country [1].

We will go into social security branches sickness insurance (reimbursement of medical costs) and incapacity for work (benefits in cash), which are administered by ourinstitution (Hulp- en voorzorgskas voor zeevarenden, Caisse de Secours et de Prévoyance en faveur des marins, Relief and Provident Fund for seafarers) for the branches family benefits, accidents at work and pensions you can find the references to the competent institutions hereunder.

Applicable legislation 

As a general rule EU resident seafarers employed on Belgian flag vessels are socially insured in Belgium. (“…an activity as an employed or self-empoyed person normally pursued on board a vessel at sea flying the flag of a Member State shall be deemed to be an activity pursued in the said Member State….” Article 11.4 of EC Regulation 883/2004).  According to an agreement between Belgium and Luxemburg you can also be socially insured  in Belgium while being employed on a Luxemburg flag vessel.  This means that your social security contributions are paid inBelgium and thatBelgium therefore is the “competent state” for your social security coverage.

The fact that you (and perhaps your family) live in another country of the European Union (most likely, but not necessarily, your home country) does not alter this premise. Within the European Union procedures have been worked out in order to assure that you can exercise your ‘Belgian rights’ in your country of residence.

Competent institution

Hulpkas voor Ziekte- en Invaliditeitsverzekering (HZIV)   
Caisse Auxiliaire d'Assurance Maladie-Invalidité (CAAMI)

Frankrijklei 81-83 bus 3         
2000 Antwerpen   
Belgium   
Tel.: +32 3 220 74 61   
E-mail: @email

If you are unable to find the answer to your particular question in the following paragraphs, you can always contact this institution at the above-mentioned postal or e-mail address.

Sickness insurance - Benefits in kind

How to obtain benefits in kind when you (and your family) reside in a member state of the European Union other than the state where you are socially insured (Belgium)?

Context

As a general rule seafarers navigating under the Belgian flag are socially insured in Belgium. (“an activity as an employed or self-employed person normally pursued on board a vessel at sea flying the flag of a Member State shall be deemed to be an activity pursued in the said Member State” article 11, 4 of EC Regulation 883/2004). This means that your social security contributions are paid inBelgium and thatBelgium therefore is the “competent state” for your social security coverage.

The fact that you (and perhaps your family) live in another country of the European Union (most likely, but not necessarily, your home country) does not alter this premisse. Within the European Union procedures have been worked out in order to assure that you can exercise your ‘Belgian rights’ in your country of residence.

In general

If you reside in another country than the country in which you are insured (Belgium), you and the members of your family will be granted the benefits in kind in your country of residence according to the legislation of that country as if you were actually insured there. For this to be the case, you firstly need to fulfil the conditions of the Belgian legislation; one of these conditions is, as you know, registration in the Belgian Pool of seafarers. All conditions fulfilled, you will then be awarded the benefits in kind by the institution of the place of residence*, at the expense of our institution (HZIV-CAAMI).

This means that it is the Belgian legislation that decides whether there is a right to benefits. Once this has been established, the benefits are granted by the residence country as if you were actually entitled to benefits in that state.

You can claim benefits provided for under the legislation of the residence country only. This means that if a certain benefit is provided for in the Belgian legislation but not provided for under the legislation of your residence country, you cannot claim these benefits to be awarded in your residence country. 

Your family members will only be entitled to benefits in kind in the country of residence if they are recognised as family members according to the legislation of the country of residence.

Competent institution

 

Hulpkas voor Ziekte- en Invaliditeitsverzekering” (HZIV)   
Caisse Auxiliaire d'Assurance Maladie-Invalidité (CAAMI)

Frankrijklei 81-83 bus 3   
2000 Antwerpen   
Belgium   
Tel.: +32 3 220 74 61   
E-mail: @email

 

How does it work? 

In the following paragraphs we list the essential rules that govern your consumption of benefits in kind in your country of residence. The information is based on EC Regulation 987/2009 which prescribes the rules in this matter. Your own responsibilities and those of the institution of the place of residence* and of the competent institution intertwine.

Registration at the institution of your place of residence

  1. In order to receive benefits in kind you must register yourself and the members of your family (if they fulfil the conditions laid down in the legislation of the State of residence) with the institution of your place of residence* by submitting a document (model form E 106) certifying that you and the members of your family are entitled to the said benefits in your place of residence. This certified statement shall be issued by our institution (HZIV-CAAMI) upon your request or upon request of the institution of the place of residence.
  2. That document shall remain valid until the institution of the place of residence has been informed by our institution of its cancellation.
  3. The institution of the place of residence shall inform our institution of every registration effected in accordance with the provisions of paragraph 1 and of any change or cancellation of that registration

Stay in or transfer of residence to Belgium

If you are insured in Belgiumand resident in another country you are also entitled to benefits when you stay in Belgium as if you were resident there. The same goes for your family members. There are no procedures to be followed except national procedures.

If you, insured in Belgium, transfer your residence to Belgium there is entitlement to benefits in Belgium only. The entitlement to benefits in the former country of residence ceases. The same goes for your members of family transferring their residence to Belgium

Stay in another Member State (not Belgium or country of residence)

When you stay in another country than your country of residence, you are entitled to benefits from the country of stay at the expense of our institution if the condition necessitates immediate treatment or other benefits. 

To that end you must present a European Health Insurance Card (EHIC) issued by our institution, indicating your entitlement to benefits in kind. You will be treated then as if you were insured in the country of stay. If you do not present this EHIC the institution of the country of stay may ask for the card directly from our institution.  Please contact us when you will stay in another member state and we will send you an EHIC.

Stay in another Member State (not Belgium or country of residence) in order to receive treatment

You could be authorised to go to another country in order to receive treatment there, if this treatment is among the benefits provided for by the legislation in the Member State where you reside and where that treatment cannot be given within a time limit which is medically justifiable, taking into account the current state of health and the probable course of the illness.

When authorisation is given our institution will issue a model form E 112 BE. The form E 112 BE shall contain information on for what period there is entitlement to benefits. The provision also covers your family members. 

 

Institutions of the place of residence

What follows is a link to find “institutions of the place of residence”. As we have explained above, those are the institutions with which you have the most direct contact. It is therefore highly recommended to take contact with this institution, also prior to any immediate cause, just ‘to know what you’re up to’. This same institution also takes care of your application for benefits in cash in case of incapacity for work (see our info on “Sickness Insurance – benefits in cash”)

http://ec.europa.eu/employment_social/social-security-directory/

Sickness insurance - Benefits in cash

What to do in case of incapacity for work when you reside in a member state of the European Union other than the state where you are socially insured (Belgium)?

Context

As a general rule seafarers navigating under the Belgian flag are socially insured in Belgium. (“an activity as an employed or self-employed person normally pursued on board a vessel at sea flying the flag of a Member State shall be deemed to be an activity pursued in the said Member State” article 11,4 of EC Regulation 883/2004). This means that your social security contributions are paid inBelgium and thatBelgium therefore is the “competent state” for your social security coverage.

The fact that you (and perhaps your family) live in another country of the European Union (most likely, but not necessarily, your home country) does not alter this premisse. Within the European Union procedures have been worked out in order to assure that you can exercise your ‘Belgian rights’ in your country of residence.

In general

The fact that you reside in another country than the country in which you are socially insured (Belgium), implies that your potential ‘benefits in cash’ will be granted to you in your country of residence, but according to the Belgian legislation. This means that it is the Belgian legislation that decides whether there is a right to benefits in cash in case of incapacity for work. Once this right has been established, the benefits are (in most cases) directly granted to you by our institution.

Compentent institution

 

Hulpkas voor Ziekte- en Invaliditeitsverzekering (HZIV)   
Caisse Auxiliaire d'Assurance Maladie-Invalidité (CAAMI)

Frankrijklei 81-83 bus 3   
2000 Antwerpen   
Belgium   
Tel.: +32 3 220 74 61   
E-mail: @email

How to obtain benefits in cash?

  1. In the following paragraphs we list the essential stages of the procedure which has to be followed in a case of incapacity for work. The information is based on EC Regulation 987/2009 which prescribes the rules in this matter. Your own responsibilities and those of the institution of the place of residence* and of the competent institution intertwine. You should ask the doctor, in your State of residence, who established your state of health to certify your incapacity for work and its probable duration. You can use the form included hereby.
  2. You should send this certificate within three days of the commencement of the incapacity for work to the HZIV-CAAMI. If the incapacity for work starts during a journey at sea you have three days from the day you disembark.
  3. If the doctors in your State of residence do not issue certificates of incapacity for work, you should apply directly to the institution of your place of residence.  This institution shall immediately arrange for medical assessment of your incapacity for work and for the certificate referred to in paragraph 1 to be drawn up.  The certificate shall be forwarded to the HZIV-CAAMI.
  4. The forwarding of the document referred to in paragraph 1, 2 and 3 shall not exempt you from fulfilling the obligations provided for by the applicable legislation, in particular with regard to your employer. Where appropriate, the employer and/or the HZIV-CAAMI may call upon you to participate in activities designed to promote and assist your return to employment.
  5. At the request of the HZIV-CAAMI, the institution of the place of residence shall carry out any necessary administrative checks or medical examinations of you in accordance with the legislation it applies. The report of the examining doctor concerning, in particular, the probable duration of the incapacity for work, shall be forwarded without delay by the institution of the place of residence to the HZIV-CAAMI.
  6. The HZIV-CAAMI shall reserve the right to have the insured person examined by a doctor of its choice.
  7. In general the HZIV-CAAMI shall pay the cash benefits directly to you and shall, where necessary, inform the institution of the place of residence thereof.
  8. The particulars of the certificate of incapacity for work drawn up in another State of the EU on the basis of medical findings of the examining doctor or institution shall have the same legal value as a certificate drawn up in Belgium.
  9. If the HZIV-CAAMI refuses the cash benefits, it shall notify its decision to you and at the same time to the institution of the place of residence.
  10. Paragraphs 1 to 9 shall apply even when you stay in a Member State other than Belgium.

Institutions of the place of residence

What follows is a link to find “institutions of the place of residence”. As we have explained above, those are the institutions with which you have the most direct contact. It is therefore highly recommended to take contact with this institution, also prior to any immediate cause, just ‘to know what you’re up to’. This same institution also takes care of your application for benefits in kind (see our info on “Sickness Insurance – benefits in kind”) 

http://ec.europa.eu/employment_social/social-security-directory/

 

EU Countries are: Austria, Belgium, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, The Netherlands, Poland, Portugal, Slovenia, Slovak Republic, Spain, Sweden, United Kingdom, Bulgaria, Romania and Croatia.